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Introduction

Since the first cases of acquired immunodeficiency syndrome (AIDS) were
reported in the United States in 1981, the human immunodeficiency virus
(HIV) that causes AIDS and other HIV-related diseases has precipitated an
epidemic unprecedented in modern history. Because the virus is transmitted
almost exclusively by behavior that individuals can modify, educational
programs to influence relevant behavior can be effective in preventing the
spread of HIV (1-5).

The guidelines below have been developed to help school personnel and
others plan, implement, and evaluate educational efforts to prevent
unnecessary morbidity and mortality associated with AIDS and other
HIV-related illnesses. The guidelines incorporate principles for AIDS
education that were developed by the President's Domestic Policy Council
and approved by the President in 1987 (see Appendix I).

The guidelines provide information that should be considered by persons
who are responsible for planning and implementing appropriate and effective
strategies to teach young people about how to avoid HIV infection. These
guidelines should not be construed as rules, but rather as a source of
guidance. Although they specifically were developed to help school
personnel, personnel from other organizations should consider these
guidelines in planning and carrying out effective education about AIDS for
youth who do not attend school and who may be at high risk of becoming
infected. As they deliberate about the need for and content of AIDS
education, educators, parents, and other concerned members of the community
should consider the prevalence of behavior that increases the risk of HIV
infection among young people in their communities. Information about the
nature of the AIDS epidemic, and the extent to which young people engage in
behavior that increases the risk of HIV infection, is presented in Appendix
II.

Information contained in this document was developed by CDC in
consultation with individuals appointed to represent the following
organizations:
American Academy of Pediatrics
American Association of School Administrators
American Public Health Association
American School Health Association
Association for the Advancement of Health Education
Association of State and Territorial Health Officers
Council of Chief State School Officers
National Congress of Parents and Teachers
National Council of Churches
National Education Association
National School Boards Association
Society of State Directors of Health, Physical Education,
Recreation and Dance
U.S. Department of Education
U.S. Food and Drug Administration
U.S. Office of Disease Prevention and Health Promotion
Consultants included a director of health education for a state department
of education, a director of curriculum and instruction for a local
education department, a health education teacher, a director of school
health programs for a local school district, a director of a state health
department, a deputy director of a local health department, and an expert
in child and adolescent development.

Planning and Implementing Effective School Health Education about AIDS

The Nation's public and private schools have the capacity and
responsibility to help assure that young people understand the nature of
the AIDS epidemic and the specific actions they can take to prevent HIV
infection, especially during their adolescence and young adulthood. The
specific scope and content of AIDS education in schools should be locally
determined and should be consistent with parental and community values.

Because AIDS is a fatal disease and because educating young people about
becoming infected through sexual contact can be controversial, school
systems should obtain broad community participation to ensure that school
health education policies and programs to prevent the spread of AIDS are
locally determined and are consistent with community values.

The development of school district policies on AIDS education can be an
important first step in developing an AIDS education program. In each
community, representatives of the school board, parents, school
administrators and faculty, school health services, local medical
societies, the local health department, students, minority groups,
religious organizations, and other relevant organizations can be involved
in developing policies for school health education to prevent the spread of
AIDS. The process of policy development can enable these representatives to
resolve various perspectives and opinions, to establish a commitment for
implementing and maintaining AIDS education programs, and to establish
standards for AIDS education program activities and materials. Many
communities already have school health councils that include
representatives from the aforementioned groups. Such councils facilitate
the development of a broad base of community expertise and input, and they
enhance the coordination of various activities within the comprehensive
school health program (6).

AIDS education programs should be developed to address the needs and the
developmental levels of students and of school-age youth who do not attend
school, and to address specific needs of minorities, persons for whom
English is not the primary language, and persons with visual or hearing
impairments or other learning disabilities. Plans for addressing students'
questions or concerns about AIDS at the early elementary grades, as well as
for providing effective school health education about AIDS at each grade
from late elementary/middle school through junior high/senior high school,
including educational materials to be used, should be reviewed by
representatives of the school board, appropriate school administrators,
teachers, and parents before being implemented.

Education about AIDS may be most appropriate and effective when carried
out within a more comprehensive school health education program that
establishes a foundation for understanding the relationships between
personal behavior and health (7-9). For example, education about AIDS may
be more effective when students at appropriate ages are more knowledgeable
about sexually transmitted diseases, drug abuse, and community health. It
may also have greater impact when they have opportunities to develop such
qualities as decision-making and communication skills, resistance to
persuasion, and a sense of self-efficacy and self-esteem. However,
education about AIDS should be provided as rapidly as possible, even if it
is taught initially as a separate subject.

State departments of education and health should work together to help
local departments of education and health throughout the state
collaboratively accomplish effective school health education about AIDS.
Although all schools in a state should provide effective education about
AIDS, priority should be given to areas with the highest reported incidence
of AIDS cases.

Preparation of Education Personnel

A team of representatives including the local school board,
parent-teachers associations, school administrators, school physicians,
school nurses, teachers, educational support personnel, school counselors,
and other relevant school personnel should receive general training about
a) the nature of the AIDS epidemic and means of controlling its spread, b)
the role of the school in providing education to prevent transmission of
HIV, c) methods and materials to accomplish effective programs of school
health education about AIDS, and d) school policies for students and staff
who may be infected. In addition, a team of school personnel responsible
for teaching about AIDS should receive more specific training about AIDS
education. All school personnel, especially those who teach about AIDS,
periodically should receive continuing education about AIDS to assure that
they have the most current information about means of controlling the
epidemic, including up-to-date information about the most effective health
education interventions available. State and local departments of education
and health, as well as colleges of education, should assure that such
in-service training is made available to all schools in the state as soon
as possible and that continuing in-service and pre-service training is
subsequently provided. The local school board should assure that release
time is provided to enable school personnel to receive such in-service
training.

Programs Taught by Qualified Teachers

In the elementary grades, students generally have one regular
classroom teacher. In these grades, education about AIDS should
be provided by the regular classroom teacher because that person
ideally should be trained and experienced in child development,
age-appropriate teaching methods, child health, and elementary
health education methods and materials. In addition, the
elementary teacher usually is sensitive to normal variations in
child development and aptitudes within a class. In the secondary
grades, students generally have a different teacher for each
subject. In these grades, the secondary school health education
teacher preferably should provide education about AIDS, because a
qualified health education teacher will have training and
experience in adolescent development, age-appropriate teaching
methods, adolescent health, and secondary school health education
methods and materials (including methods and materials for
teaching about such topics as human sexuality, communicable
diseases, and drug abuse). In secondary schools that do not have
a qualified health education teacher, faculty with similar
training and good rapport with students should be trained
specifically to provide effective AIDS education.

Purpose of Effective Education about AIDS

The principal purpose of education about AIDS is to prevent HIV
infection. The content of AIDS education should be developed with
the active involvement of parents and should address the broad
range of behavior exhibited by young people. Educational programs
should assure that young people acquire the knowledge and skills
they will need to adopt and maintain types of behavior that
virtually eliminate their risk of becoming infected.

School systems should make programs available that will enable
and encourage young people who have not engaged in sexual
intercourse and who have not used illicit drugs to continue to--

Abstain from sexual intercourse until they are ready to
establish a mutually monogamous relationship within the
context of marriage;

Refrain from using or injecting illicit drugs.

For young people who have engaged in sexual intercourse or who
have injected illicit drugs, school programs should enable and
encourage them to--

Stop engaging in sexual intercourse until they are ready to
establish a mutually monogamous relationship within the
context of marriage;

To stop using or injecting illicit drugs.

Despite all efforts, some young people may remain unwilling to
adopt behavior that would virtually eliminate their risk of
becoming infected. Therefore, school systems, in consultation
with parents and health officials, should provide AIDS
education programs that address preventive types of behavior
that should be practiced by persons with an increased risk of
acquiring HIV infection. These include:

Avoiding sexual intercourse with anyone who is known to be
infected, who is at risk of being infected, or whose HIV
infection status is not known;

Using a latex condom with spermicide if they engage in
sexual intercourse;

Seeking treatment if addicted to illicit drugs;

Not sharing needles or other injection equipment;

Seeking HIV counseling and testing if HIV infection is suspected.

State and local education and health agencies should work
together to assess the prevalence of these types of risk
behavior, and their determinants, over time.

Content

Although information about the biology of the AIDS virus, the
signs and symptoms of AIDS, and the social and economic costs of
the epidemic might be of interest, such information is not the
essential knowledge that students must acquire in order to
prevent becoming infected with HIV. Similarly, a single film,
lecture, or school assembly about AIDS will not be sufficient to
assure that students develop the complex understanding and skills
they will need to avoid becoming infected.

Schools should assure that students receive at least the
essential information about AIDS, as summarized in sequence in
the following pages, for each of three grade-level ranges. The
exact grades at which students receive this essential information
should be determined locally, in accord with community and
parental values, and thus may vary from community to community.
Because essential information for students at higher grades
requires an understanding of information essential for students
at lower grades, secondary school personnel will need to assure
that students understand basic concepts before teaching more
advanced information. Schools simultaneously should assure that
students have opportunitites to learn about emotional and social
factors that influence types of behavior associated with HIV
transmission.

Early Elementary School

Education about AIDS for students in early elementary grades
principally should be designed to allay excessive fears of the
epidemic and of becoming infected.

AIDS is a disease that is causing some adults to get very sick,
but it does not commonly affect children.

AIDS is very hard to get. You cannot get it just by being near or touching
someone who has it.

Scientists all over the world are working hard to find a way to stop people
from getting AIDS and to cure those who have it.

Late Elementary/Middle School

Education about AIDS for students in late elementary/middle
school grades should be designed with consideration for the
following information.

Viruses are living organisms too small to be seen by the unaided eye.

Viruses can be transmitted from an infected person to an uninfected person
through various means.

Some viruses cause disease among people.

Persons who are infected with some viruses that cause disease may not have
any signs or symptoms of disease.

AIDS (an abbreviation for acquired immunodeficiency syndrome) is caused by
a virus that weakens the ability of infected individuals to fight off
disease.

People who have AIDS often develop a rare type of severe pneumonia, a
cancer called Kaposi's sarcoma, and certain other diseases that healthy
people normally do not get.

About 1 to 1.5 million of the total population of approximately 240 million
Americans currently are infected with the AIDS virus and consequently are
capable of infecting others.

People who are infected with the AIDS virus live in every state in the
United States and in most other countries of the world.

Infected people live in cities as well as in suburbs, small towns, and
rural areas. Although most infected people are adults, teenagers can also
become infected. Females as well as males are infected. People of every
race are infected, including whites, blacks, Hispanics, Native Americans,
and Asian/Pacific Islanders.

The AIDS virus can be transmitted by sexual contact with an infected
person; by using needles and other injection equipment that an infected
person has used; and from an infected mother to her infant before or during
birth.

A small number of doctors, nurses, and other medical personnel have been
infected when they were directly exposed to infected blood.

It sometimes takes several years after becoming infected with the AIDS
virus before symptoms of the disease appear. Thus, people who are infected
with the virus can infect other people--even though the people who transmit
the infection do not feel or look sick.

Most infected people who develop symptoms of AIDS only live about 2 years
after their symptoms are diagnosed.

The AIDS virus cannot be caught by touching someone who is infected, by
being in the same room with an infected person, or by donating blood.

Junior High/Senior High School

Education about AIDS for students in junior high/senior high
school grades should be developed and presented taking into
consideration the following information.

The virus that causes AIDS, and other health problems, is called human
immunodeficiency virus, or HIV.

The risk of becoming infected with HIV can be virtually eliminated by not
engaging in sexual activities and by not using illegal intravenous drugs.

Sexual transmission of HIV is not a threat to those uninfected
individuals who engage in mutually monogamous sexual relations.

HIV may be transmitted in any of the following ways: a) by sexual contact
with an infected person (penis/vagina, penis/rectum, mouth/vagina,
mouth/penis, mouth/ rectum); b) by using needles or other injection
equipment that an infected person has used; c) from an infected mother to
her infant before or during birth.

A small number of doctors, nurses, and other medical personnel have been
infected when they were directly exposed to infected blood.

The following are at increased risk of having the virus that causes AIDS
and consequently of being infectious: a) persons with clinical or
laboratory evidence of infection; b) males who have had sexual intercourse
with other males; c) persons who have injected illegal drugs; d) persons
who have had numerous sexual partners, including male or female
prostitutes; e) persons who received blood clotting products before 1985;
f) sex partners of infected persons or persons at increased risk; and g)
infants born to infected mothers.

The risk of becoming infected is increased by having a sexual partner who
is at increased risk of having contracted the AIDS virus (as identified
previously), practicing sexual behavior that results in the exchange of
body fluids (i.e., semen, vaginal secretions, blood), and using unsterile
needles or paraphernalia to inject drugs.

Although no transmission from deep, open-mouth (i.e., "French") kissing
has been documented, such kissing theoretically could transmit HIV from an
infected to an uninfected person through direct exposure of mucous
membranes to infected blood or saliva.

In the past, medical use of blood, such as transfusing blood and treating
hemophiliacs with blood clotting products, has caused some people to become
infected with HIV. However, since 1985 all donated blood has been tested to
determine whether it is infected with HIV; moreover, all blood clotting
products have been made from screened plasma and have been heated to
destroy any HIV that might remain in the concentrate. Thus, the risk of
becoming infected with HIV from blood transfusions and from blood clotting
products is virtually eliminated. Cases of HIV infection caused by these
medical uses of blood will continue to be diagnosed, however, among people
who were infected by these means before 1985.

Persons who continue to engage in sexual intercourse with persons who are
at increased risk or whose infection status is unknown should use a latex
condom (not natural membrane) to reduce the likelihood of becoming
infected. The latex condom must be applied properly and used from start to
finish for every sexual act. Although a latex condom does not provide 100%
protection--because it is possible for the condom to leak,break, or slip
off--it provides the best protection for people who do not maintain a
mutually monogamous relationship with an uninfected partner. Additional
protection may be obtained by using spermicides that seem active against
HIV and other sexually transmitted organisms in conjunction with condoms.

Behavior that prevents exposure to HIV also may prevent unintended
pregnancies and exposure to the organisms that cause Chlamydia infection,
gonorrhea, herpes, human papillomavirus, and syphilis.

Persons who believe they may be infected with the AIDS virus should take
precautions not to infect others and to seek counseling and antibody
testing to determine whether they are infected. If persons are not
infected, counseling and testing can relieve unnecessary anxiety and
reinforce the need to adopt or continue practices that reduce the risk of
infection. If persons are infected, they should: a) take precautions to
protect sexual partners from becoming infected; b) advise previous and
current sexual or drug-use partners to receive counseling and testing; c)
take precautions against becoming pregnant; and d) seek medical care and
counseling about other medical problems that may result from a weakened
immunologic system.

More detailed information about AIDS, including information about how to
obtain counseling and testing for HIV, can be obtained by telephoning the
AIDS National Hotline (toll free) at 800-342-2437; the Sexually Transmitted
Diseases National Hotline (toll free) at 800-227-8922; or the appropriate
state or local health department (the telephone number of which can be
obtained by calling the local information operator).

Curriculum Time and Resources

Schools should allocate sufficient personnel time and resources
to assure that policies and programs are developed and
implemented with appropriate community involvement, curricula are
well-planned and sequential, teachers are well-trained, and
up-to-date teaching methods and materials about AIDS are
available. In addition, it is crucial that sufficient classroom
time be provided at each grade level to assure that students
acquire essential knowledge appropriate for that grade level, and
have time to ask questions and discuss issues raised by the
information presented.

Program Assessment

The criteria recommended in the foregoing "Guidelines for
Effective School Health Education To Prevent the Spread of AIDS"
are summarized in the following nine assessment criteria. Local
school boards and administrators can assess the extent to which
their programs are consistent with these guidelines by
determining the extent to which their programs meet each point
shown below. Personnel in state departments of education and
health also can use these criteria to monitor the extent to which
schools in the state are providing effective health education
about AIDS.

To what extent are parents, teachers, students, and
appropriate community representatives involved in developing,
implementing, and assessing AIDS education policies and programs?

To what extent is the program included as an important part of a more
comprehensive school health education program?

To what extent is the program taught by regular classroom teachers in
elementary grades and by qualified health education teachers or other
similarly trained personnel in secondary grades?

To what extent is the program designed to help students acquire
essential knowledge to prevent HIV infection at each appropriate grade?

To what extent does the program describe the benefits of abstinence for
young people and mutually monogamous relationships within the context
of marriage for adults?

To what extent is the program designed to help teenage students avoid
specific types of behavior that increase the risk of becoming infected
with HIV?

To what extent is adequate training about AIDS provided for school
administrators, teachers, nurses, and counselors--especially those who
teach about AIDS?

To what extent are sufficient program development time, classroom time,
and educational materials provided for education about AIDS?

To what extent are the processes and outcomes of AIDS education being
monitored and periodically assessed?

References

1. US Public Health Service. Coolfont report: a PHS plan for
prevention and control of AIDS and the AIDS virus. Public
Health Rep 1986;101:341.

Appendix I

The President's Domestic Policy Council's Principles for AIDS Educat

The following principles were proposed by the Domestic Policy
Council and approved by the President in 1987:

Despite intensive research efforts, prevention is the only effective AIDS
control strategy at present. Thus, there should be an aggressive Federal
effort in AIDS education.

The scope and content of the school portion of this AIDS education effort
should be locally determined and should be consistent with parental values.

The Federal role should focus on developing and conveying accurate health
information on AIDS to the educators and others, not mandating a specific
school curriculum on this subject, and trusting the American people to use
this information in a manner appropriate to their community's needs.

Any health information developed by the Federal Government that will be
used for education should encourage responsible sexual behavior--based on
fidelity, commitment, and maturity, placing sexuality within the context of
marriage.

Any health information provided by the Federal Government that might be
used in schools should teach that children should not engage in sex and
should be used with the consent and involvement of parents.

Appendix II

The Extent of AIDS and Indicators of Adolescent Risk

Since the first cases of acquired immunodeficiency syndrome (AIDS) were
reported in the United States in 1981, the human immunodeficiency virus
(HIV) that causes AIDS and other HIV-related diseases has precipitated an
epidemic unprecedented in modern history. Although in 1985, fewer than 60%
of AIDS cases in the United States were reported among persons residing
outside New York City and San Francisco, by 1991 more than 80% of the cases
will be reported from other localities (1).

It has been estimated that from 1 to 1.5 million persons in the United
States are infected with HIV (1), and, because there is no cure, infected
persons are potentially capable of infecting others indefinitely. It has
been predicted that 20%-30% of individuals currently infected will develop
AIDS by the end of 1991 (1). Fifty percent of those diagnosed as having
AIDS have not survived for more than about 1.5 years beyond diagnosis, and
only about 12% have survived for more than 3 years (2).

By the end of 1987, about 50,000 persons in the United States had been
diagnosed as having AIDS, and about 28,000 had died from the disease (2).
Blacks and Hispanics, who make up about 12% and 6% of the U.S. population,
respectively, disproportionately have contracted 25% and 14% of all
reported AIDS cases (3). It has been estimated that during 1991, 74,000
cases of AIDS will be diagnosed, and 54,000 persons will die from the
disease. By the end of that year, the total number of deaths caused by AIDS
will be about 179,000 (1). In addition, health care and supportive services
for the 145,000 persons projected to be living with AIDS in that year will
cost our Nation an estimated $8-$10 billion in 1991 alone (1). The World
Health Organization projects that by 1991, 50-100 million persons may be
infected worldwide (4). The magnitude and seriousness of this epidemic
requires a systematic and concerted response from almost every institution
in our society.

A vaccine to prevent transmission of the virus is not expected to be
developed before the next decade, and its use would not affect the number
of persons already infected by that time. A safe and effective antiviral
agent to treat those infected is not expected to be available for general
use within the next several years. The Centers for Disease Control (5), the
National Academy of Sciences (6), the Surgeon General of the United States
(7), and the U.S. Department of Education (8) have noted that in the
absence of a vaccine or therapy, educating individuals about actions they
can take to protect themselves from becoming infected is the most effective
means available for controlling the epidemic. Because the virus is
transmitted almost exclusively as a result of behavior individuals can
modify (e.g., by having sexual contact with an infected person or by
sharing intravenous drug paraphernalia with an infected person),
educational programs designed to influence relevant types of behavior can
be effective in controlling the epidemic.

A significant number of teenagers engage in behavior that increases their
risk of becoming infected with HIV. The percentage of metropolitan teenage
girls who had ever had sexual intercourse increased from 30%-45% between
1971 and 1982. The average age at first intercourse for females remained at
approximately 16.2 years between 1971 and 1979 (9). The average proportion
of never-married teenagers who have ever had intercourse increases with age
from 14 through 19 years. In 1982, the percentage of never-married girls
who reported having engaged in sexual intercourse was as follows:
approximately 6% among 14-year-olds (10), 18% among 15-year-olds, 29% among
16-year-olds, 40% among 17-year-olds, 54% among 18-year-olds, and 66% among
19-year-olds (11). Among never-married boys living in metropolitan areas,
the percentage who reported having engaged in sexual intercourse was as
follows: 24% among 14-year-olds, 35% among 15-year-olds, 45% among 16-year
olds, 56% among 17-year-olds, 66% among 18-year olds, and 78% among 19-year
olds (9,12). Rates of sexual experience (e.g., percentage having had
intercourse) are higher for black teenagers than for white teenagers at
every age and for both sexes (11,12).

Male homosexual intercourse is an important risk factor for HIV
infection. In one survey conducted in 1973, 5% of 13- to 15-year-old boys
and 17% of 16- to 19-year-old boys reported having had at least one
homosexual experience. Of those who reported having had such an
experience, most (56%) indicated that the first homosexual experience had
occurred when they were 11 or 12 years old. Two percent reported that they
currently engaged in homosexual activity (13).

Another indicator of high-risk behavior among teenagers is the number of
cases of sexually transmitted diseases they contract. Approximately 2.5
million teenagers are affected with a sexually transmitted disease each
year(14).

Some teenagers also are at risk of becoming infected with HIV through
illicit intravenous drug use. Findings from a national survey conducted in
1986 of nearly 130 high schools indicated that although overall illicit
drug use seems to be declining slowly among high school seniors, about 1%
of seniors reported having used heroin and 13% reported having used cocaine
within the previous year (15). The number of seniors who injected each
of these drugs is not known.

Only 1% of all the persons diagnosed as having AIDS have been under age
20 (2); most persons in this group had been infected by transfusion or
perinatal transmission. However, about 21% of all the persons diagnosed as
having AIDS have been 20-29 years of age. Given the long incubation period
between HIV infection and symptoms that lead to AIDS diagnosis (3 to 5
years or more), some fraction of those in the 20- to 29-year-age group
diagnosed as having AIDS were probably infected while they were still
teenagers.

Among military recruits screened in the period October 1985-December
1986, the HIV seroprevalence rate for persons 17-20 years of age
(0.6/1,000) was about half the rate for recruits in all age groups
(1.5/1,000) (16). These data have lead some to conclude that teenagers and
young adults have an appreciable risk of infection and that the risk may be
relatively constant and cumulative (17).

Reducing the risk of HIV infection among teenagers is important not only
for their well-being but also for the children they might produce. The
birth rate for U.S. teenagers is among the highest in the developed world
(18); in 1984, this group accounted for more than 1 million pregnancies.
During that year the rate of pregnancy among sexually active teenage girls
15-19 years of age was 233/1,000 girls (19).

Although teenagers are at risk of becoming infected with and transmitting
the AIDS virus as they become sexually active, studies have shown that they
do not believe they are likely to become infected (20,21). Indeed, a random
sample of 860 teenagers (ages 16-19) in Massachusetts revealed that,
although 70% reported they were sexually active (having sexual intercourse
or other sexual contact), only 15% of this group reported changing their
sexual behavior because of concern about contracting AIDS. Only 20% of
those who changed their behavior selected effective methods such as
abstinence or use of condoms (20). Most teenagers indicated that they want
more information about AIDS (20,21).

Most adult Americans recognize the early age at which youth need to be
advised about how to protect themselves from becoming infected with HIV and
recognize that the schools can play an important role in providing such
education. When asked in a November 1986 nationwide poll whether children
should be taught about AIDS in school, 83% of Americans agreed, 10%
disagreed, and 7% were not sure (22). According to information gathered by
the United States Conference of Mayors in December of 1986, 40 of the
Nation's 73 largest school districts were providing education about AIDS,
and 24 more were planning such education (23). Of the districts that
offered AIDS education, 63% provided it in 7th grade, 60% provided it in
9th grade, and 90% provided it in 10th grade. Ninety-eight percent provided
medical facts about AIDS, 78% mentioned abstinence as a means of avoiding
infection, and 70% addressed the issues of avoiding high-risk sexual
activities, selecting sexual partners, and using condoms. Data collected by
the National Association of State Boards of Education in the summer of 1987
indicated that a) 15 states had mandated comprehensive school health
education; eight had mandated AIDS education; b) 12 had legislation pending
on AIDS education, and six had state board of education actions pending; c)
17 had developed curricula for AIDS education, and seven more were
developing such materials; and d) 40 had developed policies on admitting
students with AIDS to school (24).

The Nation's system of public and private schools has a strategic role to
play in assuring that young people understand the nature of the epidemic
they face and the specific actions they can take to protect themselves from
becoming infected-- especially during their adolescence and young
adulthood. In 1984, 98% of 14 and 15 year-olds, 92% of 16 and 17 year-olds,
and 50% of 18 and 19 year-olds were in school (25). In that same year,
about 615,000 14- to 17-year-olds and 1.1 million 18- to 19-year-olds were
not enrolled in school and had not completed high school (26).

References

US Public Health Service. Coolfont report: a PHS plan for
prevention and control of AIDS and the AIDS virus. Public Health Rep
1986;101:341.

Johnston LD, Bachman JG, O'Malley PM. Drug use among American high
school students, college, and other young adults: national trends
through 1986. Rockville, Md: National Institute on Drug Abuse, 1987.

United States Conference of Mayors. Local school districts active
in AIDS education. AIDS Information Exchange 1987;4:1-10.

Cashman J. Personal communication on September 8, 1987, about the
National Association of State Boards of Education survey of state
AIDS-related policies and legislation. Washington, DC: National
Association of State Boards of Education.

US Department of Commerce, Bureau of the Census. Statistical
abstract of the United States, 105th ed. Washington, DC: US Department
of Commerce, 1985.

US Department of Commerce, Bureau of the Census. School
enrollment--social and economic characteristics of students: October
1984. Current Population Reports. Washington, DC: US Department of
Commerce, 1985 (Series P-20, No. 404).

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